Joseph Conway, MD, FACS

Benign Eyelid Lesions

Benign cysts

These include epidermoid cysts, dermoid cysts, sweat ductal cysts and epidermal inclusion cysts. As they are benign, they are easily treatable, though the treatment option for each varies.

Inflammatory lesions

While technically these are not tumors, they must be borne in mind when making a diagnosis of cancer. Lesions include hordoleum (stye), chalazion and parasitic infections.

Style often need antibiotics and surgical drainage, chalazion benefits from simple observation and hot compresses if required, along with a gentle massage, while parasitic infections might need anti-parasitic medication.

Vascular lesions

Hemangiomas are vascular lesions that can mimic eye tumors. They might be a capillary hemangioma, cavernous hemangioma or a lymphangioma. They are often seen in infants and children. If found, it needs fairly urgent treatment as it can have an impact on vision and result in blindness.

Treatments include steroids (administered as a ointment or injection), laser photocoagulation and surgical excision if required.

Benign epithelial lesions

These include squamous papillomas, seborrhoeic keratosis, inverted follicular keratosis and keratoacanthoma. Squamous papillomas appear round or pedunculated and have a smooth surface.

They can be removed surgically or in some cases interferon might be used. Seborrhoeic keratosis is often monitored for a change in shape or size before any treatment is considered. They often need a biopsy to confirm their benign nature.

Pre-malignant lesions

A number of different eyelid lesions might become cancerous. They include Actinic keratosis, leukoplakia, Xeroderma pigmentosum and radiation dermatosis.

Common viral lesions

include molluscum contagiosum, verruca vulgaris , herpes simplex and herpes zoster. Molluscum contagiosum is seen in individuals with low immunity, and can cause conjunctivitis.

They are treated with cryotherapy or excision. Herpes simplex and zoster are treated with antiviral agents.

Other lesions

These include Xanthelasma, nevi and Caruncular Tumors. Most are benign and require simple treatments. Xanthalesma is associated with high cholesterol levels in the blood. Nevi need excision if they change size or shape

mole or birthmark with irregular border and changes in size, thickness or texture

6 mm large lesion which appears after age 20 and is pigmented

sore spot that fails to heal

Treatment

The surgeon might remove the tumor and have a pathologist check the tissue margins ("frozen section") to be sure the tumor is completely removed. Alternatively, a dermatologic surgeon might excise the tumor in a special way ("Mohs technique") to ensure total removal.

Once the tumor has been completely removed, reconstructive surgery is usually necessary. Reconstructive surgery is performed to make a new eyelid or repair the defect.

Needless to say, the goal is to reconstruct the eyelid so that it functions perfectly, protects the eye, preserves vision, and has a satisfactory cosmetic appearance. The patient must keep in mind that any form of therapy for eyelid skin cancer will leave a scar. However, an effort is always made to minimize scarring and obtain optimal cosmetic results.

After surgery, the healing process might take six months to one year. Once the wound has healed, follow-up with your physician is necessary to be sure that the skin cancer does not recur. Should there be development of a new cancer, it can then be detected early and treated promptly.